


Garreg Mach Mental Hospital: Doctor's Notes

by Catcateightyeight



Series: Garreg Mach Mental Hospital: Fire Emblem Three Houses [4]
Category: Fire Emblem: Fuukasetsugetsu | Fire Emblem: Three Houses
Genre: Doctor/Patient, Implied/Referenced Suicide, Mental Health Issues
Language: English
Status: In-Progress
Published: 2020-03-17
Updated: 2020-04-05
Packaged: 2021-03-01 05:07:21
Rating: Mature
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 8
Words: 2,270
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/23189741
Author URL: https://archiveofourown.org/users/Catcateightyeight/pseuds/Catcateightyeight
Summary: This is the private property of Dr. Byleth Eisner. In compliance with HIPPA policy, keep out.
Series: Garreg Mach Mental Hospital: Fire Emblem Three Houses [4]
Series URL: https://archiveofourown.org/series/1627006
Comments: 12
Kudos: 22





	1. Cover

**Composition Notebook**

* * *

This notebook is the private property of Dr. Byleth Eisner. Reading or altering the notes written on these pages is prohibited by all unauthorized personal. Keep Out. (That means you, sis.) _*_

_*But I am Dr. Byleth Eisner O_O_

I'm being serous Byleth...

_ME TOO XD_

>:(

_< 3_


	2. Dimitri Intake

Dimitri Alexandre Blaiddyd

Arrived at Garreg Mach Medical Campus after the fire at Blaiddyd Co headquarters. The fire was powerful and spread quickly. Fire team reports suspect arson. He arrived with third degree burns and was unconscious due to smoke inhalation. He received emergency surgery to remove his badly damaged eye. After being kept in a medically induced coma for a few days while his burns healed, he woke up disoriented. My sister and I were called in to examine him three days after he woke up.

Patient seems only partially coherent. Our conversations with him are frequently interrupted by his conversations with people we can’t see. His eye never focuses on us for long, and floats around the room as if glancing between other people. Based on the way he responds to the hallucinations, I suspect the things they say to him are hostile and demeaning. However, the patient also seems to recognize his hallucinations. He called one of them “mom.”

_ The patient’s memory of the incident seems to be lacking, or non-existent. When asked about it, he only gives half committed answers. He seems to understand that he was in a fire, moreso by the fact that he is covered in burns and not from his own memory. Dimitri also does not remember the man he carried out of the building with him, or the piece of rebar they had to remove from his shoulder. They were the only survivors. _

Patient history has no record of mental illness. Nor is there any mental illness in his family's records. We were fortunate enough to already have access to his medical files, since his GP was on campus. The MRI we ordered shows no swelling or physical damage to his brain. All structures are present and normal. There is no scientific explanation for his sudden hallucinations.  _ Except the extensive trauma he underwent. _

Current Diagnosis: schizophrenia

Prescribing: Olanzapine and Aripiprazole  _ and ~~Fluoxetine~~ * _

_ *Patient is also showing signs of depression when not overwhelmed by hallucinations. _

Let’s wait on the Fluoxetine to see how the patient tolerates the first two.  _ Agreed. _


	3. ???? Intake

_~~????~~ *Dedue _

_ We were called in to examine the other survivor of the Blaiddyd Co. fire. He has been unresponsive since the fire.  _ *  _ When we arrived, he didn’t acknowledge us. Throughout the entire examination he did not look at us once, just stared out the window. He makes no facial expressions, never grunts or humms in response to anything, does not speak. _

* He responds to physical stimulus, as evident by a paralisis test done by some nurses after his burns healed enough. His vitals are steady. Brain scans show reaction when given auditory and visual stimulus.

_ The Paitent appears to be from out of the city, possibly out of country, based on his physical appearance. There is a chance that he doesn’t understand the language that is being spoken to him, but has made no effort to request a translator. A police investigation has not turned up any information on him. No passport, no ID, no family have come to visit. There are no records of him in our hospital system. _

_ As such, we don’t have any medical history or family medical history on this mystery patient. He seems to be in good health other than his burns and broken leg, and there is no damage to the vocal cords. We don’t know if his silence is a historical issue or a new one since the incident. The only other person who has a chance of knowing who he is, is currently non-coherent  _ (Dimitri).

Current Theroised Diagnosis: Progressive Mutism from a childhood issue with Selective Mutism or self inflicted silence from the recent trauma.

Prescription: Extensive talk therapy and gentle resocialization.

_ * Dimitri, upon seeing him again for the first time since hospitalization, muttered the word “Dedue,” before wandering off. No one knows if this was just more incoherent rambling, or if Dimtri remembered something about the patient, but the name seems to have stuck. Everyone has been calling him Dedue since. _


	4. Dorothea Intake

Dorothea Arnault

I was personally requested to examine this patient (or specifically, not my sister). She was physically in good health. Seems chipper despite being in the Mental Hospital’s intake interview. She went on happily about her theater and singing hobbie, her grades in school above average. The patient seemed a little tired, maybe a little stressed, but nothing I wouldn’t expect from an 18 year old girl working her way through adolescent and High School.

When I spoke with her parents they insisted something was “off” about her. She hadn’t been acting the same in weeks and they were worried about her. Sometimes a parent’s intuition can be a powerful diagnostic tool, and patients aren’t known for being forthcoming during a clinical interview.

I can’t for the life of me figure out what is wrong with her, but I admitted her for a short stay based on her parent’s suspicions. I made it clear that she would only be able to stay for a week, and if we couldn’t find anything wrong with her then we would be forced to send her home.

Current Therosied Diagnosis: Anxiety?

Prescription: food, relaxation and light talk therapy


	5. Ignatz Intake

Ignatz Victor

We were referred a patient today from a doctor on the therapeutic floor of Garrag Mach Medical Campus. He came in diagnosed with severe Obsessive Compulsive Disorder. I took the interview.

Patient arrived with a sketch book in hand. When I called him in for his interview, he seemed incapable of pulling himself away from his drawing.  _ *  _ While I asked questions he barely responded with a yes or a no, instead focusing on redrawing the same line over and over. His breathing was shallow and pupils constricted. When I got a glance at the notebook I noticed that there were places where the pages had small holes in them from how many times he had erased in the same place. Most of the interview consisted of me talking him out of his compulsion and getting him to refocus.

When I talked to the parents they were very supportive. They knew he had been struggling with OCD for a while and done everything they could to get him help. They loved that he loved his art, but were worried that his condition would prevent him from being able to get into art school. I reassured them by telling them that many great artists had debilitating mental illnesses and reminded them that art school wasn’t going anywhere. School would be ready for him when he was ready for school.

I admitted the patient for an indeterminate amount time with the parent’s blessing.

Current Diagnosis: debilitating Obsessive Compulsive Disorder

Prescription: Cognitive Behavioral Therapy, specifically Exposure and Response Prevention and Xanax as needed for anxiety

_ *Have you seen his drawings, they are spectacular! He has a bright future as an artist if he can stop erasing his work. _


	6. Marianne Intake

_ Marianne Edmund _

_ I came in to examine a patient admitted to ER after a suicide attempt. Her means had been her mother’s antidepressants. When I arrived her father was warning her not to leave her room because there could be dangerous people, who would not understand her, roaming around the hospital. _

_ During the interview I quickly noticed her low self-esteem. The patient followed up most sentences about herself with self deprecating statements. Lots of negative self talk. She admitted to me that she still wanted to kill herself. The patient already had some level of ideation of self harm, but no concrete plan yet. I made sure she was placed on suicide watch by the attending nurses and insisted they check on her every hour. _

_ I spoke with the parents. Her (step) father does not seem to be a believer in mental health, insisting that this was just a phase, all she needed was a little attitude adjustment. Her mother thought otherwise and thankfully talked her father into having her admitted. Mother also admited to a history of Depression. _

_ Current Diagnosis: Major Depressive Disorder, Suicidal _

_ Prescription: Citalopram, talk therapy, Dialectical Behavioral Therapy _


	7. Caspar Intake

Caspar Bergliez

We were called in to examine a return patient with severe autism. Before entering the room we were cornered by one of the nurses who told us that this was not the first time this patient had been admitted with blood in his urine from a UTI and malnourished, but the first time doctors from the Mental Hospital had been called to examine him. A few of the medical doctors suspected neglect, and thought the best way to insure that the patient was cared for was to have him admitted for treatment in the secure mental ward.

_ I was skeptical at first, worried that the doctors were just trying to take advantage of the Mental Hospital’s funds to get the patient out of an unideal situation. Sometimes it is hard to get autistic people to cooperate enough to keep them healthy. I was wrong _

When we entered the room only the patient and an attendant were present. We had been told his brother had been there with him, but the brother was not present. Caspar was obviously malnourished, possibly emaciated given how his bones stuck out from under his skin.  _ He seemed to be in decent spirits, carrying on a broken conversation with the attendant about boxing. _

The patient appears to be able to understand conversation very well, following along with complex words and sentence structures. However, speech is very poor. He seems to struggle to get words out of his throat, emphasizing vowels so strongly sometimes it is hard to understand him. When nervous he rocks and wrings his hands close to his chest. Appears to be incapable of controlling his drooling or snot, but unbothered by it.

His brother showed up part way through the interview with a can of soda he apparently had to go to a gas station just off of campus to attain. ( _ The prick.  _ Be nice Byleth.) He seemed uninterested in what we had to say and only expressed concerns about his parents being able to afford an extended stay in the hospital when we brought up having the patient admitted.

_ We got the chance to speak privately with the attendant. While sitting with the patient and his brother, she had learned that the patient did not have a regular schedule nor had ever received speech therapy. He was regularly confined to his room and only rarely given the opportunity to interact with people outside of the family. She also pointed out rope burns on his wrists and told us that they had apparently been tying his hands down to keep him from doing “that creepy grabby thing with his chest.”  _

We did not speak with the parents. After a short phone call with the brother, he told us that he would be taking the patient home as soon as he was released from the ER.

Diagnosis: UTI, malnourished, Autism, signs of abuse and neglect.

Prescription: Doxycycline, increased diet, recommended speech therapy, recommended admittance to Black Eagle Ward for specialized treatment

_ I hope he comes back and we are able to admit him. It irks me to think he is going back to that awful place. I am going to leave an official statement with the ER secretaries that if they see him again to call us and pay close attention to signs of abuse and neglect. We will also be writing an official report to Adult Protective Services, since we are mandatory reporters. _

I will also leave a statement with the ER unit.


	8. Sylvain Intake

Sylvain Jose Gautier

_ We were assigned as Sylvain’s primary psychiatrists after his admittance to the Blue Lion’s Ward, and were not a part of his intake interview. The notes mention that he is self admitted, being legally an adult, for addiction. Specifically Hypersexual Disorder. I did not speak with him until a day after his arrival. _

_ He was easily distracted by flirting with me. It took some time for me to get him to focus on conversation about his symptoms and history. Every time we broached a subject that was difficult he would fall back into flirting and crude humor. I suspect this is a safety mechanism for him at this point. _

_ The patient admits to seaking out sexual release upwards of four times a day, with different or multiple partners. He admits to partaking in risky behavior, such as not wearing protection and trying to have sex in public locations (ie. public restrooms). The patient has a few different pornographic sights saved to his phone for easy access. Nothing he has admitted to doing has been illegal. _

I was there when settling the patient into his room. He looked exhausted and stressed, not caring much that his parents, brother and I were standing there when he striped down to his boxers and climbed into bed. As he did I noticed that there are scars on his back, like someone had taken a horse whip to him. The scars are old and well healed. I also noticed that the parents were unsupportive and disappointed.

Symptoms could stem from possible childhood abuse.  _ I suspect there is some kind of physical relationship between the patient and the brother based on my session with Sylvain. Whether sexual or violent is undetermined. _

Diagnosis: Hypersexual Disorder, Chlamydia

Prescription: Cognitive Behavioral Therapy, Group Therapy, Doxycycline 


End file.
